1. A week in the life of……..! Alison MacLean Senior Infection Prevention & Control Nurse NHS Highland

2. Annus horribilis 2012

3. January outbreak of Clostridium difficile – 6 patients in a surgical ward March outbreak of Clostridium difficile – 3 patients in the oncology ward June-Unannounced HEI visit – 9 requirements – 2 recommendations

4. Exemplar ward Concept of an exemplar ward suggested by Lead Nurse, Una Lyons. Ensure all process where correct Ward 4C, surgical ward was identified Action plan created

5. Ivory Tower Stephen R Covey, ‘The 7 Habits of Highly Effective People’, Habit 5 – Seek first to understand, then to be understood! Out of my ivory tower and back to the shop floor!!!

6. Day 1-Domestic Assistant Hardest days work I’ve ever done! Resulted in a review of when was the most appropriate time for the clinical areas to be cleaned. Fewer staff available at the weekends and evenings. Single DSR per floor-time spent looking for keys Became invisible

7. Day 2-Domestic Supervisor Suggested use of inventory for DSR to reduce amount of time spent fetching stock Increased awareness of environmental monitoring tool Issues with bodily fluids!

8. Day 3-Nursing Auxiliary How easy is it to do the right thing? Use of PPE, hand hygiene and appropriate disposal. Reinstated clinical waste bins in multi bed bays. Housekeepers appointed.

9. Day 4-Staff Nurse Aligned IP&CN to each division Induction process for new staff. Testing use of booklet/checklist Ward environment Team members Documentation Training requirements

10. Conclusion Ward have continued to progress-currently doing SICPs compliance measurement. No evidence of spread of infection. HEI unannounced revisit in November – 1 requirement – 2 recommendations

11. Cleanliness Champions Programme Good basic foundation Opportunity to reflect on current practice Improve processes